Bilateral Pure Facet Joint Dislocation in Thoracolumbar Junction (T11-T12) Without Facet Fracture Using a 3D Digital Printing Model for Surgical Planning: A Case Report

Background: Thoracolumbar junction pure bilateral facet joint dislocation without facet fracture is an extremely rare injury. A current review of thoracolumbar junction pure bilateral facet joint dislocation reported less than 15 cases in which the surgeon had a difficulty with the dissection of surgical planning using only 2D radiographic film and the axial or coronal view in computerized tomography. Bilateral pure facet joint dislocation in the thoracolumbar junction without facet fracture is difficult to understand the morphology of bone injuries.

Case Presentation: A 25-year-old Thai gentleman presented with paraplegia and loss of sensation in the lower extremity (ASIA A) following a fall from a high lorry. Radiographic film and computed tomography scan revealed pure facet dislocation T11-T12 without facet fracture. The patient's thoracolumbar junction of the spine is presented to describe the three-dimensional (3D) printing technique for surgical preoperative planning. After the patient underwent open reduction, decompression and instrumentation with posterolateral fusion, the patient's thoracolumbar junction was described in the three-dimensional (3D) printing again for follow-up and in order to help the surgeon understand about the morphology and alignment after surgery.

Conclusion: Pure facet dislocation is rarely seen at the thoracolumbar junction; it is a very unstable injury. In this case, we performed an early investigation using a 3D digital printing model in order to help with orthopedic surgical planning, emergency early open reduction and instrumentation with fusion. Neurological status was recovered. The 3D digital printing model should be a standard investigation in rare cases of orthopedic surgical planning.